Multilingual defibrillator

ABSTRACT

This invention relates to an external defibrillator whose language of operation can be easily changed when the defibrillator is deployed for use. Defibrillators include, manual defibrillators, automatic or semi-automatic external defibrillators (&#34;AEDs&#34;) and defibrillator trainers. In one embodiment, the invention provides a way to change the language in which the defibrillator delivers instructions to a user. Defibrillators of this invention would contain multiple languages in their memory. During the set-up of the defibrillator some or all of the languages could be designated as a language in which a prompt will be offered. Additionally, during set-up, one language will be designated as the default language. Once the defibrillator is deployed for use in an emergency, the operator will indicate a language preference for the defibrillator operating instructions. Once the user has indicated which language the prompts should be in, the defibrillator will then begin instructing the user in the use of the defibrillator in that language. Conversely, if the user fails to make any language preference indication, the defibrillator will begin instructing the user in the use of the defibrillator in the default language. In an alternate embodiment, the defibrillator issues each instruction in multiple languages.

RELATED APPLICATION

This application is a continuation-in-part of U.S. patent applicationSer. No. 09/000,807 filed Dec. 30, 1997, now abandoned.

BACKGROUND OF THE INVENTION

The invention relates to an external defibrillator whose language ofoperation can be easily changed when the defibrillator is deployed foruse. Defibrillators include, manual defibrillators, automatic orsemi-automatic external defibrillators ("AEDs"), defibrillator/monitorcombinations, advisory defibrillators and defibrillator trainers.

Sudden cardiac arrest ("SCA") most often occurs without warning,striking people with no history of heart problems. It is estimated thatmore than 1000 people per day are victims of sudden cardiac arrest inthe United States alone, which translates into a needless death every 2minutes.

SCA results when the electrical component of the heart no longerfunctions properly; this results in an abnormal sinus rhythm. One suchabnormal sinus rhythm, ventricular fibrillation ("VF"), is caused byabnormal and very fast electrical activity in the heart. VF may betreated by applying an electric shock to the patient's heart through theuse of a defibrillator. The shock clears the heart of abnormalelectrical activity (in a process called "defibrillation") by producinga momentary asystole and providing an opportunity for the heart'snatural pacemaker areas to restore normal function. If, however, theheart has not been pumping blood for more than 5 minutes, there is anincreased likelihood that the victim either will not be resuscitated orwill suffer irreversible brain damage. Quick response is thereforenecessary. By providing voice and text prompts for the user, the amountof time necessary to review protocols prior to deploying thedefibrillator would be reduced.

Over the last several years defibrillators have become more portable andhave begun moving into the hands of first responders. As a result,equipment that was once available only in the hospital environment isnow being used by police officers, flight attendants and securityguards, to name a few, as part of a first-line action in theadministration of first aid. The benefit of making this equipmentavailable to the first responders is that it is more likely that avictim of SCA will receive the life saving shock within the first fewcritical minutes.

Additional information regarding SCA and first aid (including CPR) maybe obtained from the American Heart Association internet website atwww.amhrt.org. [See, also, Cummins, et al "Improving Survival fromSudden Cardiac Arrest: The `Chain of Survival` Concept" Circulation83:1832-1847 (1991)].

Currently available external defibrillators often display instructions,status information or other information to assist the defibrillatoroperator in operating the defibrillator. Some external defibrillatorsannounce such information audibly through a speaker, either in additionto displaying information or instead of displaying information. Forexample, the FORERUNNER® AED by Heartstream notifies the operator that ashock is advised using both audible and visual prompts and instructs theoperator to deliver a shock by pressing the appropriate button. Moredetailed information directed to defibrillators can be found, forexample, in Cameron et al. U.S. Pat. No. 5,607,454 and Cole et al. U.S.Pat. No. 5,611,815.

Prior art defibrillators are typically pre-programmed with a singlelanguage for displays or announcements. If a defibrillator programmedfor use in one language must be used in a country or region where apotential user speaks a different language, the defibrillator must bereprogrammed to display and/or announce the information in a differentlanguage. Such programming and re-programming usually take place beforethe defibrillator is placed into service, and must take place before thedefibrillator is deployed to treat a victim in an emergency. Thus it isnecessary to know the language of the defibrillator operator (or user)who will be using a defibrillator prior to making the defibrillatoravailable for use in an emergency.

In another implementation, the Hewlett-Packard CodeMaster defibrillatoris provided with multiple languages in memory (typically 9-1). However,the operation language must be selected using the set-up menu which isactivated using a three-key combination. Because the set-up menuinactivates the defibrillator operation, language selection is typicallyperformed when the device is placed into service. Once the operationlanguage has been set-up it cannot be changed again without interruptingthe defibrillator operation.

In an area, such as Quebec, Canada, where more than one language iscommonly spoken, not necessarily with equal proficiency, it would bedesirable to have a defibrillator that adapts the language of theprompts in response to the user's indication of language proficiency.There are other geographic areas where such ad hoc language selectionwould also be beneficial. Additionally, as defibrillators become morecommonly available, the need for the defibrillator to be able tocommunicate with many different potential users, particularly in anethnically diverse community, will become increasingly important.

Further, it would be desirable to provide a mechanism to change thelanguage of the defibrillator at a later time during operation. Forexample, if a second tier responder (such as an EMT) arrives who has adifferent language proficiency than the first tier responder, it wouldbe advantageous to be able to change the operation language of thedevice without disabling the defibrillator operation.

Many other defibrillators, including manual defibrillators, anddefibrillator trainers have been developed and are known in the art,although not discussed herein.

The disclosures of the patents cited herein are incorporated byreference.

What has been needed is a defibrillator where the language of theprompts, either written and/or audible, can be selected by the user atthe time that the defibrillator is deployed for use in an emergency.Where the defibrillator is used as a trainer, the language of theprompts are selected by the user when the defibrillator is deployed foruse in a simulated emergency, or in the training environment.

SUMMARY OF THE INVENTION

This invention provides an easy way to change the language in adefibrillator at the time the defibrillator is deployed or after thedefibrillator is in use.

This invention provides an external defibrillator comprising acontroller, and an energy delivery system that is operable by thecontroller to deliver an electrical shock from an energy source to anelectrode interface. The invention further provides an instructiongenerator which has an input for interacting with the externaldefibrillator operator to select a language and an instruction generatorfor providing instructions to a defibrillator operator in a languagebased on the information from the instruction generator.

The defibrillator may have languages loaded into the memory. Thedefibrillator may also provide a multiplicity of language selectionbuttons that enable the user to select a language.

Alternatively, the defibrillator may be programmed to perform allinstructions in more than one language. As a result, the defibrillatorwould operate in a multiplicity of languages sequentially.

This invention is also directed to a method of selecting the operationlanguage of an external defibrillator where a defibrillator operator isprompted to select a language in a first prompting language. Once thedefibrillator receives the selection from the operator, thedefibrillator determines whether the language is available in memory andthen selects the language from the defibrillator's memory. Thedefibrillator then uses the selected language to provide instructions tothe operator.

Further the defibrillator may allow the selected language to be changed,as needed, during the operation of the defibrillator.

The method may also provide for the language to be displayed forselection visually or to be announced audibly. Additionally, the methodmay provide for additional languages to be displayed for selectionvisually or to be announced audibly.

BRIEF DESCRIPTION OF THE DRAWINGS

FIG. 1 is a diagrammatic representation of a defibrillator system.

FIG. 2 is a flow chart demonstrating a defibrillator operating accordingto the current invention wherein the user selects a preferred language.

FIG. 3 is a flow chart demonstrating a defibrillator operating accordingto an alternate embodiment of the invention shown in FIG. 2.

FIGS. 4A and 4B are a top elevational view of a defibrillator for usewith this invention.

FIG. 5 is a schematic diagram of an external defibrillator for use withthis invention.

FIG. 6 is a schematic block diagram of a defibrillator operatingaccording to an alternate embodiment wherein the defibrillatordetermines operation language based on user response to a command.

FIG. 7 is a flow chart demonstrating a defibrillator operating accordingto an alternate embodiment wherein the defibrillator deliversinstructions in a multiplicity of languages sequentially.

DETAILED DESCRIPTION OF THE PREFERRED EMBODIMENTS

FIG. 1 is a schematic block diagram of a defibrillator system 10according to a preferred embodiment of this invention. The defibrillatorsystem 10 comprises an energy source 12 to provide voltage or currentpulses. A controller 20 operates an electrode delivery system 19 toselectively connect and disconnect energy source 12 to and from a pairof electrodes 16 electrically attached to a patient 18 through anelectrode interface 14 to provide electrotherapy to the patient. Thedefibrillator system 10 may be a manual defibrillator or AED.Alternatively, defibrillator system 10 may be a defibrillator trainerthat simulates the behavior of a manual or automatic/semi-automaticdefibrillator in use, in which case the electrode interface and energydelivery system may be omitted.

In addition, controller 20 performs a protocol using information from aninstruction generator 22. The controller 20 and instruction generator 22determine the language of the defibrillator instructions based oninformation from the user. The instruction generator 22 may include amemory device such as FLASH, EEPROM, ROM or RAM containing software codeused to generate visual and audible instructions. Instruction generator22 may also include a gate array or other control logic.

The instructions may be delivered via an instruction output 23, whichconsists in this embodiment of a visual image generator 24 and anaudible sound generator 26. Visual image generator 24 may display, amongother things, commands to the user (either written or graphicrepresentations). The visual image generator 24 may be, for example, aliquid crystal display ("LCD"). Additionally, an audible sound generator26 may be provided that broadcasts audible commands from the instructiongenerator 22. Audible commands include verbal commands directing theuser in the operation of the defibrillator 10. Activation of the visualimage generator 24 and the audible sound generator 26 is controlled bythe controller 20 in response to the information received from theinstruction generator 22.

Additionally, user input 28 may be provided to interact with theinstruction generator 22 to select the desired language of defibrillatoroperating instructions. In the embodiment shown in FIG. 1, the userinput 28 interacts with the instruction generator 22 via controller 20.The user input may interact directly with the instruction generator inother embodiments.

FIG. 2 is an example of a defibrillator operation method according tothis invention. Using prompts in language "1", where language "1" is thefirst language that the prompts are delivered in, the defibrillatorrequests the user to select the language 100. The request may beaudible, visual (on the display), or a combination of the two. Iflanguage "1" is selected 102, the defibrillator begins prompting theuser in the procedures to deploy and use the defibrillator in language"1" 104.

If the user does not select language "1" 102, then the defibrillatorrequests the user to select a language in language "2" 110, wherelanguage "2" is the second language that the prompts are delivered in.Again, if language "2" is selected 112, then the defibrillator beginsprompting the user in the procedures to deploy and use the defibrillatorin language "2" 114.

If the user does not select language "2", the defibrillator continues torequest the user to select a language in each of the languagesdesignated during the set-up until the defibrillator reaches language N120, where N is the number of languages that have been loaded into thedefibrillator memory and designated during language prompt set-up. Oncethe defibrillator reaches language N 120, the defibrillator makes itsfinal request for language selection from the user. If language N isselected, then the defibrillator will begin prompting the user in theprocedures to deploy and use the defibrillator in the selected language.

If, however, the language N, or any previous language, has not beenselected, the defibrillator begins prompting the user in the proceduresto deploy and use the defibrillator in the default language X 126, whereX is the language that has been designated as the default language forthe defibrillator. The defibrillator may be programmed so that itreverts to the default language after passage of a specific amount oftime. For example, if the defibrillator reaches language N, thedefibrillator could request the user to select language N and if thereis no response within, for example, 5-30 seconds, the defibrillatorcould begin prompting in the default language X

In one embodiment, prior to deploying the defibrillator, i.e. prior toplacing the defibrillator into service so that it is available forimmediate use during an emergency, the defibrillator has promptsinstalled in the languages that will be needed in the location where thedefibrillator is placed into service. Each installed language can beassigned a priority number. One of the installed languages will beidentified as the default language.

For example, in Quebec N could be two languages, where French islanguage 1 and English is language 2. The priority of the languagescould be set so that French is followed by English, with the defaultlanguage being French. It is important to note, however, that thedefault language need not be the first prompting language. So, forexample, for the same defibrillator in Quebec, where French is the firstlanguage, and English is the second language, the default language couldbe set at English.

In another example, such as in Europe, N could be three languages, whereFrench is language 1, German is language 2 and English is language 3.Again, the default language could be set to be of the three languages.

In another embodiment, prior to deploying the defibrillator, thedefibrillator will have prompts installed in several, or all, languages.Each language is assigned an identifier, such as a number, so that theprompts, once selected, can be quickly retrieved from memory. Eachdefibrillator is then programmed, or set-up, to prompt only for thelanguages selected during the set-up. The languages selected forprompting could be all or less than all of the languages available inthe defibrillator's memory. An example of a language table that might beused is show in Table 1.

                  TABLE 1                                                         ______________________________________                                        Language ID        Language Name                                              ______________________________________                                        01                 English                                                    02                 British English                                            03                 Canadian English                                           04                 Australian English                                         05                 French                                                     06                 Canadian French                                            07                 German                                                     08                 Italian                                                    09                 Spanish                                                    ______________________________________                                    

For example, in Quebec Canada a defibrillator could have prompts in allof the languages shown in Table 1 installed in memory, but be programmedto ask the user for the language prompt in Canadian English (03) and inCanadian French (06) only. The priority of the languages could be set sothat Canadian French (06) is first, followed by Canadian English (03),with a default of Canadian French (06). As with the previous embodiment,the default language need not be the first language the defibrillator isprogrammed to use in requesting language selection. A more detailedexample of such a language table is shown in Table 2.

                  TABLE 2                                                         ______________________________________                                        Default  Sequence Language ID  Language Name                                  ______________________________________                                                          01           English                                                          02           British English                                         1        03           Canadian English                                                 04           Australian English                                               05           French                                         .check mark.                                                                           2        06           Canadian French                                                  07           German                                                           08           Italian                                                          09           Spanish                                        ______________________________________                                    

It is important to note that neither Table 1 nor Table 2 is anexhaustive list of languages; they are merely provided for illustrationpurposes.

As illustrated in Table 2, the designation of "1" and "2" for thelanguage selection is typically independent of the language ID, and isused primarily to indicate the sequence of the language prompt. Othermeans of indicating order, such as "A", "B", "C" can be used withoutdeparting from the scope of the invention. It should be noted, as well,that the number designating order could, in some or all instances, alsocorrelate to the language ID number. In such cases, the language ID andthe priority can be combined into a single designation without departingfrom the scope of the invention.

In a typical embodiment of the invention shown in FIG. 2, adefibrillator will be set-up to prompt the user in two to six languages;the defibrillator may, however, be set-up to prompt the user in morethan six languages in some instances.

FIG. 3 shows a method of operating a defibrillator according to analternative embodiment of this invention. The defibrillator requests theuser to indicate a language preference 200. Such a request may be madeby, for example, displaying, either simultaneously or sequentially, thephrase "select language" or "indicate language preference" in a numberof languages. The display may, alternatively, show only a list of thenames of the languages in the language. Alternatively, the request maybe made by, for example, an audible request to "select language" or"indicate language preference" sequentially in a number of languages.The request may also be made by a combination of audible and visualmeans.

The user then selects a language 202. The user may select the languageby using, for example, buttons on the defibrillator or other inputdevices to scroll through the list of available languages (listed eithersimultaneously or sequentially on the visual display as described above)until the desired language is high-lighted. Each language shown wouldappear named in the language it represents. For example, Spanish wouldappear as "Espanol". Thereafter, the user would, for example, pressanother button to select the language.

Once the user selects a language 202, the defibrillator looks at thelanguages available in memory to determine whether or not the selectedlanguage is available 204. If the language is available, then thedefibrillator begins prompting the user in the procedures to deploy anduse the defibrillator in the selected language 206. If the selectedlanguage is not available, then the defibrillator displays a messageindicating that the language is "not available" and requests the user toselect a second language preference 210. The "not available," orequivalent message indicating that the language selected is unavailable,can be displayed visually, or can be audibly generated, or a combinationof the two. Such visual display can be a graphic indication (such as theinternational NO symbol ".O slashed.", a flashing or solid hand, or aflashing or solid "X") or a text indication. Where a text indication isused, one or more languages can be used to convey the message to theuser prior to requesting the user to select a next language. A moredetailed example of a language table that would be used in thisembodiment is shown in Table 3.

                  TABLE 3                                                         ______________________________________                                        Avail-                                                                              Dis-                  Language                                                                             Screen Language                            able  play   Default Sequence                                                                             ID     Display                                                                              Name                                ______________________________________                                        YES   YES    .check mark.                                                                          1      01     English                                                                              English                             NO    YES                   02     British                                                                              British                                                                English                                                                              English                             NO    NO                    03     Canadian                                                                             Canadian                                                               English                                                                              English                             NO    NO                    04     Australian                                                                           Australian                                                             English                                                                              English                             YES   YES            2      05     Français                                                                     French                              NO    NO                    06     Français                                                                     Canadian                                                               Canadien                                                                             French                              YES   YES            3      07     Deutsch                                                                              German                              YES   YES            4      08     Italiano                                                                             Italian                             YES   YES            5      09     Espanol                                                                              Spanish                             ______________________________________                                    

Once the user selects a second language 212, the defibrillator looks atthe languages available in memory to determine whether or not theselected language is available 214. If the language is available, thenthe defibrillator begins prompting the user in the procedures to deployand use the defibrillator in the selected language 216. If the selectedlanguage is not available, then the defibrillator displays a messageindicating that the language is "not available" and requests the user toselect another or "next" language 220.

Once the user selects the N language 222, where N is the highest numberof times that the defibrillator has been set-up to ask for a languageselection. The defibrillator then looks at the languages available inmemory to determine whether or not the selected language is available224. If the language is available, then the defibrillator beginsprompting the user in the procedures to deploy and use the defibrillatorin the selected language 226. If the selected language is not available,then the defibrillator begins prompting the user in the procedures todeploy and use the defibrillator in the default language 228.

Turning to a specific example, using the information shown in Table 3,the defibrillator has been loaded with 6 languages. The languagesdisplayed on the screen are: English, British English, French, German,Italian and Spanish. The only languages that are actually available inmemory, however, are: English, French, German, Italian and Spanish. Inthis instance, if a user were to select "British English" which isdisplayed as an option, but is not available, the user would receive amessage advising the user that British English was not available. In apreferred embodiment, however, only languages that were available forselection would actually be displayed as viable options to the user toavoid such an error message.

The defibrillator would continue to prompt the user for a languageselection N times. Note that N does not necessarily correlate to thenumber of languages added into memory. For example, N could be 3. Inthat instance, if after 3 selections, the user has not requested anavailable language (such as where the user continues to request BritishEnglish, which is not available), the defibrillator would automaticallybegin prompting the user in the default language. Using the informationprovided in Table 3, the defibrillator would begin to prompt in English.Another advantage of this design is that it allows the user todynamically make language selections. For example, a first tierresponder can select a language with which he or she has increasedproficiency. Thereafter, when the second tier responder arrives he orshe may change the language selection, if appropriate, to correspondwith their language proficiency.

In a preferred embodiment, the invention is incorporated into theHeartstream FORERUNNER® AED. As shown in FIG. 4A, the FORERUNNER AED 400has four user inputs: an on/off or power button 402; a shock button 404;and two display contrast buttons 406 and 408. An LCD 410 provides textand/or graphic display and a speaker 412 provides audio output.

In operation, the display 410 could list one or more languages, and theuser could use the contrast button 408 to scroll through the list untilthe desired language is high lighted. Thereafter, the user could use,for example, the up contrast button 406 to actually select the language.The instructions would then be visible on the display 410 or audiblethrough the speaker 412, or a combination thereof Additionally, if thedefibrillator was relying on voice instructions from the user (asdiscussed below), the phenomes would be received through the microphone(not shown in FIGS. 4A or 4B).

FIG. 5 is a schematic representation of some internal components of theFORERUNNER AED 400 shown in FIG. 4A. AED control functions are dividedamong a microprocessor unit (MPU) 502 and two custom gate arrays 504 and506. For example, MPU 502 controls the functions of contrast buttons 506and 508, as shown by block 508 in FIG. 5, while gate array 504 controlsLCD 410 and speaker 412, as shown by blocks 518 and 520 in FIG. 5.Further details regarding the remaining components of FIG. 5 may befound in U.S. Pat. No. 5,749,913, the disclosure of which isincorporated herein by reference.

In an alternative method of selecting language, a multiplicity ofadditional language specific buttons may be provided on thedefibrillator which are each labeled with a single language. Forexample, a defibrillator could have two additional buttons labeled"Français" and "English" which the user would press to select prompts ineither French or English. In operation, the language selection could bechanged at any time during operation of the defibrillator to anotherlanguage simply by pressing the desired language button. So, forexample, if the defibrillator was a bilingual defibrillator with Frenchand English a user could easily switch between the two languages bypressing the corresponding language button. This would be particularlyadvantageous in a situation where the first responder was, for example,proficient in English and the second tier responder was, for example,proficient in French because the language operation could be changedseamlessly without interrupting the operation of the defibrillator.

Alternatively, a "smart" button could be provided which has an LCDdisplay on the button. The LCD could be used to reflect the languageselection. In another embodiment, a "soft key" could be provided such ascontrast button 458 shown in FIG. 4B. Where a soft key is used, thelanguage selected could remain displayed on the screen 460, with anarrow pointing to the key that is functioning as a "soft key" 458. Inthe event, the user wishes to change the language selection, the userwould press the button indicated by the display (in this case 458) toactivate the language selection software. Thereafter, the user couldscroll through a list of available languages on the screen in order tomake a new selection. It is important to note that the dynamic changingof the operation language need not interrupt defibrillator operation(which includes functioning of the patient analysis system).

In yet another alternative embodiment of selecting language, the usercould state the name of the desired language, such as "Deutsch","Français", "Espanol" or "English". The defibrillator would then usevoice recognition software to translate the phonemes of the spokenresponse into a corresponding language selection. Translations systemsand methods of translating speech are known in the art and are notdiscussed herein. (See, e.g., Linebarger, et al. U.S. Pat. No.5,652,897; Pallakoffet al. U.S. Pat. No. 5,651,096; Rivers U.S. Pat. No.5,615,301; Strong U.S. Pat. No. 5,613,036; and Chou U.S. Pat. No.5,583,761).

FIG. 6 shows an alternative embodiment wherein the defibrillatordetermines the prompt language from the user's response to instructionsusing the microprocessor to time the response. This is another exampleof how the defibrillator selects a prompt by using a result sensed bythe machine. Using prompts in language 1, where language 1 is the firstlanguage that the prompts are delivered in, the defibrillator requeststhe user to, for example, "apply pads" 600. If the defibrillator detectsthat the pads have been applied following the prompt in language 1 andprior to the prompt in language 2, then the defibrillator will continueproviding the remaining prompts in language 1 604.

If, on the other hand, the defibrillator does not detect that the padshave been applied within a reasonable amount of time, typically from 5to 30 seconds, 602, the defibrillator will request the user to, forexample, "apply pads" in language 2 610. If the defibrillator detectsthat pads have been applied following the prompt in language 2 and priorto the prompt in language 3, then the defibrillator will provide theremaining prompts in language 2 614.

If, however, the defibrillator does not detect that the pads have beenapplied within a reasonable amount of time, typically from 5 to 30seconds, 612, the defibrillator will request the user to, for example,"apply pads" in language N 620. If the defibrillator determines that thepads were applied following the prompt in language N and prior to theprompt in language X then the defibrillator will continue prompting theuser in language N 624. If the defibrillator does not detect that thepads have been attached following the prompt in language N, then thedefibrillator will continue prompting the user in default language X626.

The amount of time the defibrillator will wait before reverting to thedefault prompts can be set at the time language priorities are set inthe defibrillator. As described above, if the user does not respond tothe prompt within a reasonable amount of time, for example, 5 to 30seconds, the defibrillator could begin prompting the user in a secondlanguage. More specifically, the defibrillator could prompt the user to"apply pads" in English. If the defibrillator does not detect that thepads have been applied, the defibrillator could then begin instructingthe rescuer to "apply pads" in another language. The defibrillator couldcontinue the prompting in different languages until the defibrillatordetects that the pads have been attached. Once the defibrillator detectsthat the pads have been attached, the defibrillator will continueprompting the user to continue the operation of the defibrillator in thelanguage used immediately prior to the pad connection. If during a laterprompt the defibrillator provides an instruction which is not respondedto, such as "deliver shock now, press the orange button", thedefibrillator will again begin delivering the prompt in differentlanguages with pauses in between to allow the user time to respond. Inthis situation, if the user spoke English, but due to nervousness didnot respond to an "apply pads" command until after receiving theinstruction to "apply pads" in, for example, Spanish, the user wouldthen receive the later commands in Spanish. When the user failed torespond to the later command, the defibrillator would then begin cyclingthrough the languages until a command in English was provided. In bothsituations, the defibrillator could be programmed to continue promptingin the default language once it has cycled through the availablelanguages without a detected response.

As will be appreciated by those skilled in the art, "apply pads" neednot be the first instruction provided to the user.

More specific examples of language order and default settings aredescribed above and illustrated in Tables 1 through 3.

FIG. 7 shows an alternative embodiment wherein the defibrillatoroperates in more than one language. Using prompts in language 1, wherelanguage 1 is the first language that the prompts are delivered in, thedefibrillator requests the user to, for example, "apply pads" 700.Thereafter the defibrillator issues the same prompt in language 2 702.As will be appreciated by those of skill in the art, the prompts can bedelivered with no pause between commands, or with a pause. If desired,the same prompt can be delivered in another language, up to N languages704. However, ideally, the defibrillator will limit the number of promptlanguages to no more than three in order to prevent a delay indefibrillation to the patient.

Following the issuance of the first instruction in a multiplicity oflanguages, the defibrillator will then instruct the rescuer in the nextprompt in language 1 710, followed by the same prompt in language 2 712,followed by the same prompts in additional languages to language N 714.This sequential delivery of prompts in a multiplicity of languagescontinues throughout the operation of the defibrillator.

The examples described above in Tables 1 through 3 of language order anddefault settings are applicable to this invention as well.

Variations in the style of prompts are also encompassed in thisinvention. For example, the defibrillator could be set-up to deliverprompts in either a male voice, a female voice, or a computer generatedvoice. Additionally, the nature of the prompts can be changed to beeither more or less commanding. For example, in English, "Deliver shocknow" could be changed to "do me the favor of delivering the shock now"in another language, such as Japanese, where cultural considerationswould require less commanding verbiage.

It should be appreciated that the scope of the invention is not limitedto the embodiments described above. Various modifications andalterations might be made by those skilled in the art without departingfrom the spirit and scope of the present invention.

What is claimed is:
 1. A method of selecting an operation language of anexternal defibrillator comprising:prompting a defibrillator operator toselect a language in a first language from a plurality of languages;receiving the language selection from the operator; determining whetherthe selection is available in memory; and using the first language toprovide instructions to the operator if the selection is determined tobe available in memory when deploying the defibrillator for use on apatient.
 2. The method of claim 1 wherein the step of using the firstlanguage to provide instructions further comprises displaying thelanguage visually.
 3. The method of claim 2 wherein the step ofprompting the defibrillator operator further comprises displaying agraphical prompt to the user to select the first language.
 4. The methodof claim 1 wherein the step of using the first language to provideinstructions further comprises announcing the language audibly.
 5. Themethod of claim 1 further comprising the step of:prompting thedefibrillator operator to select a language in a second language if thefirst language is determined not to be available in memory.
 6. Themethod of claim 5 further comprising the step of determining whether thesecond prompting language is available in memory.
 7. The method of claim6 further comprising using the second language to provide instructionsto the operator if the selection is determined to be available inmemory.
 8. The method of claim 7 further comprising the stepof:prompting the defibrillator operator to select a language in a thirdlanguage if the second language is determined not to be available inmemory.
 9. The method of claim 8 further comprising the step ofdetermining whether the third prompting language is available in memory.10. The method of claim 9 further comprising using the third language toprovide instructions to the operator if the selection is determined tobe available in memory.
 11. The method of claim 1 further comprising thestep of delivering prompts in a default language if a selection is notmade by the operator.
 12. The method of claim 11 wherein the step ofprompting the defibrillator further comprises displaying a graphicalprompt to the user to select the first language.
 13. The method of claim1 wherein the step of prompting the defibrillator operator furthercomprises delivering audible prompts from an audible sound generator.